important information about our TOT CLINIC:

Due to the pandemic, we are not currently offering multi-family TOT assessments.  

We are offering individual appointments for assessment only as available.  Please call or email us for more information or to make an appointment with one of our TOT providers.

TOT clinic is for newborns to children up to 12 years of age who may need functional assessment for tethered oral tissue. Tethered oral tissue is an unusually shortened, thickened, or tightened frenulum that restricts or limits necessary range and function of the structure, often resulting in reduced oral motor skills.

Underlying structural concerns often present as a variety of symptoms, including (but not limited to) nursing pain or difficulty, slow weight gain, failure to thrive, GERD, aerophagia, gas, constipation, colic, and airway or respiratory issues. Other indicators of oral dysfunction include torticollis and cranial molding that does not resolve within the first 8 weeks.

Tethered oral tissue may refer to any oral tissue that restricts optimal function, including lingual, maxillary, labial, or buccal frena.

First Choice engages in evidence-based clinical assessment of oral tethers using the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF), the highest standard for peer-reviewed research regarding tongue tie assessment. The HATLFF has been developed to give a quantitative assessment of tongue-tie recommendations about frenotomy (release of the frenulum). The assessment received will result in a set of care recommendations based on the score your child receives during the assessment. Services rendered today are provided in a context of academic scholarship, research, and ongoing evaluations, if you should decide to become a patient at First Choice.



An intake of health and medical history

A 15-minute HATLFF assessment and score

Observations of full-body movement patterns

Recommendations based on observations

A functional assessment may include:

By consenting to a functional assessment with us, you agree and understand that:

First Choice will use a hands-on assessment for my child.  

This is not a substitute for medical or psychological treatment. 

All medical and social information on the intake form is correct to the best of my knowledge.

There will be no diagnoses of illness or disease.

There will be no prescribed pharmaceuticals.

There will be no spinal manipulations or manual therapy.

This recommendation is not a treatment plan and is not a substitute for medical care.

Your visit at a TOT clinic (alone) does not make you a patient of First Choice.


There are currently no TOT clinics scheduled.  To be notified of new TOT clinics follow us on social media!


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TOT CLinic INtake FORM